Does balneotherapy provide additive effects to physical therapy in patients with subacute supraspinatus tendinopathy? A randomized, controlled, single-blind study

Abstract

This study assessed the additional contribution of balneotherapy on physical therapy in subacute supraspinatus tendinopathy. Ninety patients with subacute supraspinatus tendinopathy were included. They were randomized into two equal groups. In group 1 (n = 45), transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound treatments, and Codman’s and range of motion (ROM) exercises were performed. In group 2 (n = 45), balneotherapy was added to the treatment program. In both groups, shoulder active ROM and handgrip strength were measured. Pain was evaluated using a Visual Analogue Scale (VAS) (rest, sleep, movement); functional assessment and quality of life were measured respectively with the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH), and the Short Form-36 health survey (SF 36) form. All measurements were repeated before and after 15 treatment sessions. There were statistically significant differences between the before and after assessment parameters in group 1 (all p < 0.05), but not for SF-36 General Health Perceptions, SF-36 Mental Health sub-parameters, and handgrip strengths. However, there were statistically significant differences between all the evaluation before and after the treatment in group 2 (all p < 0.05). When the two groups were compared in terms of alpha gains, statistically significant differences were observed in favor of group 2 in all measurements (all p < 0.05) except for SF-36 Emotional Role Difficulty and SF-36 Mental Health sub-parameters. This study shows that the addition of balneotherapy to physical therapy for subacute supraspinatus tendinopathy can make additional contributions to shoulder ROM, pain, handgrip strength, functional status, and quality of life.

Italian and Japanese public attention toward balneotherapy in the COVID-19 era

“…Balneotherapy facilities could provide to post-COVID-19 subjects neuromotor rehabilitation with in-water muscle strength and balance exercises and walking recovery (Musumeci et al 2018 ; Masiero et al 2019 ; Morer et al 2020 ) enhancing cardiac (Pagourelias et al 2011 ; Sato et al 2009 ; Yuan et al 2019 ; Persiyanova-Dubrova et al 2019 ; Karaarslan et al 2018 ) or pulmonary performance (Baldi et al 2015 ; Khaltaev et al 2020 ). Moreover, balneotherapy may contribute to the management of comorbidities frequently existing in patients recovered from COVID-19: such as obesity and additional neurological and/or musculoskeletal conditions (Bender et al 2014 ; Fioravanti et al 2015b ; Masiero et al 2018 ; Özkuk and Dilekçi 2019 ; Munteanu et al 2019 ; Özkuk and Uysal 2019 ; Koç et al 2021 ; Eröksüz et al 2020 ; Cantista and Maraver 2020 ; Takinacı et al 2019 ; Dilekçi et al 2019 , 2020 ; Kamioka et al 2020b ; Tenti et al 2020 ; Özkuk and Ateş 2020 ; Yücesoy et al 2021 ; Karaarslan et al 2021 ). Finally, balneotherapy facilities could offer post-COVID-19 subjects with psychologically supportive interventions, reducing psychological consequences such as stress, anxiety, and depression (Stier-Jarmer et al 2017 ; Yang et al 2018 ; Özkuk et al 2018 ; Naumann et al 2020 ).…”

Sleep and spa therapies: What is the role of balneotherapy associated with exercise? A systematic review

“…Only five studies showed a sample with more than one hundred participants ( Sekine et al, 2006 ; Yang et al, 2018 ; Rapolienė et al, 2020 ; Stier-Jarmer et al, 2020 ; Maindet et al, 2021 ). The studies included in the review were on healthy or sub-healthy subjects ( Sekine et al, 2006 ; Kamioka et al, 2009 ; Blasche et al, 2010 ; Latorre-Román et al, 2015 ; Stier-Jarmer et al, 2020 ) and patients affected by different pathologies (mainly chronic pathologies or syndromes, i.e., fibromyalgia ( Buskila et al, 2001 ; Neumann et al, 2001 ; Altan et al, 2004 ; Dönmez et al, 2005 ; Maindet et al, 2021 ), ankylosing spondylitis ( Altan et al, 2006 ; Bestaş et al, 2022 ), osteoarthritis ( Yurtkuran et al, 2006 ; Evcik et al, 2007 ), musculoskeletal pain ( Rapolienė et al, 2020 ; Özkuk and Ateş, 2020 ), morbid obesity ( Koçak et al, 2020 ), mental disorders ( Koike et al, 2013 ; Naumann et al, 2020 ) and subacute supraspinatus tendinopathy ( Koç et al, 2021 )).…”

“…Except for the study by Sekine and colleagues (2006), all the studies set up a balneotherapy intervention protocol, with more than half of the studies (sixteen) showing both an intervention and control (or with other therapies excluding balneotherapy) group ( Buskila et al, 2001 ; Neumann et al, 2001 ; Altan et al, 2004 , 2006 ; Dönmez et al, 2005 ; Yurtkuran et al, 2006 ; Kamioka et al, 2009 ; Yang et al, 2018 ; Naumann et al, 2020 ; Rapolienė et al, 2020 ; Stier-Jarmer et al, 2020 ; Özkuk and Ateş, 2020 ; Koç et al, 2021 ; Maindet et al, 2021 ; Bestaş et al, 2022 ), whereas the remaining studies did not randomize the study sample ( Evcik et al, 2007 ; Blasche et al, 2010 ; Koike et al, 2013 ; Latorre-Román et al, 2015 ; Koçak et al, 2020 ).…”

“…Also in this case, it was not possible to establish the exact number of treatment sessions in the studies by Sekine and colleagues (2006) and Yang and colleagues (2006) ( Sekine et al, 2006 ; Yang et al, 2018 ). Most of the articles reported balneotherapy session length of 20 min ( Buskila et al, 2001 ; Neumann et al, 2001 ; Dönmez et al, 2005 ; Yurtkuran et al, 2006 ; Evcik et al, 2007 ; Kamioka et al, 2009 ; Koike et al, 2013 ; Latorre-Román et al, 2015 ; Koçak et al, 2020 ; Naumann et al, 2020 ; Rapolienė et al, 2020 ; Stier-Jarmer et al, 2020 ; Özkuk and Ateş, 2020 ; Koç et al, 2021 ; Bestaş et al, 2022 ), but in some cases, it was longer (30 min or more) ( Altan et al, 2004 , 2006 ; Blasche et al, 2010 ; Yang et al, 2018 ; Maindet et al, 2021 ).…”

“…Sleep changes were considered a primary outcome in eight studies ( Altan et al, 2004 ; Sekine et al, 2006 ; Blasche et al, 2010 ; Latorre-Román et al, 2015 ; Yang et al, 2018 ; Koçak et al, 2020 ; Özkuk and Ateş, 2020 ; Bestaş et al, 2022 ), a secondary outcome in the majority of the studies ( Buskila et al, 2001 ; Dönmez et al, 2005 ; Altan et al, 2006 ; Sekine et al, 2006 ; Yurtkuran et al, 2006 ; Kamioka et al, 2009 ; Naumann et al, 2020 ; Rapolienė et al, 2020 ; Stier-Jarmer et al, 2020 ; Koç et al, 2021 ; Maindet et al, 2021 ), while it was not specified in three studies ( Neumann et al, 2001 ; Evcik et al, 2007 ; Koike et al, 2013 ). Most of the studies evaluated sleep at the beginning and the end of the balneotherapy and at several follow-up times ( Buskila et al, 2001 ; Neumann et al, 2001 ; Altan et al, 2004 , 2006 ; Dönmez et al, 2005 ; Yurtkuran et al, 2006 ; Evcik et al, 2007 ; Kamioka et al, 2009 ; Blasche et al, 2010 ; Koçak et al, 2020 ; Naumann et al, 2020 ; Rapolienė et al, 2020 ; Stier-Jarmer et al, 2020 ; Özkuk and Ateş, 2020 ; Maindet et al, 2021 ; Bestaş et al, 2022 ); whereas, four studies checked for sleep changes only at the end of the balneotherapy protocol ( Koike et al, 2013 ; Latorre-Román et al, 2015 ; Yang et al, 2018 ; Koç et al, 2021 ).…”